Search Results (1,966)

Background/Objectives: Systemic arterial hypertension is a prevalent condition associated with adverse cardiac remodeling. Echocardiography plays a crucial role in assessing cardiac structure and function in hypertensive patients. This study aimed to evaluate the changes in echocardiographic parameters in hypertensive patients over a 3-year follow-up period and assess the impact of blood pressure control and antihypertensive medication use on these changes. Methods: This observational cohort study included 131 adult patients with systemic arterial hypertension who underwent annual echocardiographic assessments. Statistical analyses included paired and unpaired comparisons, regression modeling, and subgroup analyses by BP control and lifestyle behavior. Results: Over the 3-year follow-up, mean left ventricular mass (LVM) increased significantly from 173.99 ± 59.33 g to 183.26 ± 64.19 g (p = 0.018), and the prevalence of LV hypertrophy rose from 29.0% to 40.5% (p = 0.021). Patients with uncontrolled blood pressure at the final visit had significantly greater interventricular septum and posterior wall thicknesses (p = 0.009 and p = 0.012, respectively), but no statistically significant difference in ΔLVM. Those who adopted more healthy lifestyle behaviors showed a dose-dependent reduction in LVM progression, with each additional lifestyle improvement associated with a −3.25 g change in ΔLVM (p = 0.01). Multivariable linear regression identified baseline LVM, sex, and lifestyle score as independent predictors of 3-year LVM change (model R² = 0.318). Conclusions: Our findings indicate that long-term cardiac remodeling may continue in hypertensive patients despite treatment, particularly in the presence of suboptimal BP control. Sustained lifestyle improvements were independently associated with attenuation of LVM progression. These results underscore the importance of integrating behavioral interventions alongside pharmacologic therapy in routine hypertension management. Full article

Background/Objectives: Policy implementers play a crucial role in the effective delivery of policies aiming at promoting a healthy lifestyle in the most vulnerable populations. This study aimed to explore (a) policy implementers’ knowledge and perceptions of the policy framework promoting physical activity and healthy nutrition among children in need in Greece, and (b) self-perceived barriers and facilitators of the framework implementation. The term children in need refers to children who are at risk of poverty and/or social exclusion. Methods: A qualitative study design was employed consisting of semi-structured interviews with 25 policy implementers, who represented four delivery systems (health, social protection, food, and education sectors) from three geographical regions in Greece. Interviews were completed between November and December 2023. Thematic analysis was conducted using inductive and deductive approaches to identify key themes, following data management in the N-VIVO 14 software. Results: Commonly mentioned policies that study participants were involved in included school- and/or community-level-based behavioral interventions. Participants perceived policy implementation efforts that often relied on individual initiatives as inconsistent. Most participants argued that existing policies were not tailored to the needs of children in need. Major self-perceived barriers included limited personnel training, limited facilities and infrastructure, and lack of incentives or opportunities to encourage active participation. Major self-perceived facilitators included personnel motivation, integration of nutrition and physical education into school curricula, and provision of free school meals, which was associated with regular school attendance of children from the Roma communities. Conclusions: Individual, sociocultural, and structural issues are shown to persist across different delivery systems indicating the complexity of tackling obesogenic environments, especially among children in need. This is the first study in Greece to provide evidence on self-perceived barriers and facilitators and could inform ongoing national and European efforts to address obesogenic environments in children in need. Full article

Emerging technologies present significant challenges for society as a whole. Among these, Artificial Intelligence (AI) stands out for its transformative potential, with the capacity to fundamentally reshape human thought, behavior, and lifestyle. This article seeks to explore the business-oriented perspective on how AI should be approached in Higher Education (HE) in order to serve the commercial objectives of companies. The motivation for this inquiry stems from recurrent criticisms directed at HE institutions, particularly their perceived inertia in adopting innovations, resistance to change, and delayed responsiveness to evolving labor market demands. In this context, the study examines what businesses deem essential for universities to provide in the context of AI familiarity and examines how companies envision future collaboration between the business sector and Higher Education institutions in using AI for business applications. Adopting a qualitative research methodology, this study conducted interviews with 16 middle-management representatives from international corporations operating across diverse industries. The data were analyzed using Gioia’s methodology, which facilitated a structured identification of first-order concepts, second-order themes, and aggregate dimensions. This analytical framework enabled a nuanced understanding of business expectations regarding the role of HE institutions in preparing graduates capable of meeting economic and commercial imperatives under the pressure of AI diffusion. Full article

Background/Objectives: Exposure to fine particulate matter (PM_2.5) is linked to increased cardiovascular risk, particularly in individuals with hypertension. This study examined the association between dietary patterns, lifestyle factors, and vascular inflammation among individuals with hypertension living in rural and peri-urban areas of Chiang Mai Province, Thailand. Methods: A cross-sectional pilot study was conducted among 47 participants (23 rural, 24 peri-urban). Data on dietary intake, smoking, alcohol use, anthropometry, and blood chemistry were collected. Serum intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and interleukin-6 (IL-6) were measured. Partial correlation analysis was used to examine associations with lifestyle factors, adjusting for relevant covariates. Results: Peri-urban participants had significantly higher levels of ICAM-1 [83.0 vs. 50.1 ng/mL], VCAM-1 [639.3 vs. 376.5 ng/mL], and IL-6 [4.80 vs. 1.02 pg/mL] compared to rural participants. Rural individuals reported higher intakes of antioxidant-related nutrients (selenium, β-carotene, niacin, vitamins A, B6, and C), while peri-urban individuals had higher sugar intake. Sugar intake was positively associated with ICAM-1 and VCAM-1, whereas selenium and vitamin C were inversely associated with both ICAM-1 and VCAM-1, while vitamin B6 was inversely associated with VCAM-1 only. Although rural participants had a higher rate of current smoking (34.8% vs. 4.4%), smoking and alcohol use were not significantly associated with inflammatory markers. Conclusion: Rural dietary patterns may be linked to reduced vascular adhesion molecule levels. Further studies with larger samples are warranted to clarify these associations and guide lifestyle strategies for managing vascular inflammation in PM_2.5-exposed individuals with hypertension. Full article

Background: Hispanic college students face high stress, which may increase their risk for chronic stress-related health issues. Effective and accessible stress management strategies for this population remain limited. Objective: This pilot study filled a gap by studying the effects of psychological stress on diet and physical activity habits and evaluating the impact of moderate-intensity physical exercise (MIPE) and yoga interventions on chronic psychological stress and acute stress responses among Hispanic college students. Methods: A total of 18 Hispanic college students participated in a 6-week intervention consisting of either MIPE or yoga, conducted twice weekly. Anthropometric measurements and lifestyle data were collected at both pre- and post-intervention timepoints. Psychological stress was evaluated using the Perceived Stress Scale-10 (PSS-10), morning salivary cortisol concentrations, and the Trier Social Stress Test (TSST). Results: Before the intervention, both perceived stress scores and morning salivary cortisol concentrations were positively correlated with the frequency of sweetened beverage intake and negatively correlated with attitudes toward exercise. Psychological stress was not significantly reduced after MIPE or yoga interventions. The salivary cortisol response to TSST was significantly improved after the yoga intervention. Conclusions: Although this pilot exploratory study suggests that short-term yoga may have beneficial effects in managing acute stress response in Hispanic college students, the efficacy of the interventions needs to be tested and replicated in a fully powered trial. Full article

Aim: The purpose of this study was to explore the broad experience of continuous glucose monitoring from the perspective of patients diagnosed with type 1 diabetes mellitus, including not only their emotions and feelings but also the lifestyle changes, perceptions, and social aspects associated with its use. Design: This is a phenomenological qualitative study. Patient or Public Contribution: The sample consisted of 10 adult patients diagnosed with type 1 diabetes who had been using the continuous glucose monitoring system for at least 6 months and were patients of the Endocrinology and Nutrition Service of the University Hospital Complex of Ourense. Methods: The recorded interviews were conducted in November 2024. The conversations were audio-recorded with the participants’ consent, and then transcribed for thematic analysis. Results: Three main categories were identified: “experience prior to continuous glucose monitoring” (accessibility, prior knowledge, and expectations), “experience with the use of continuous glucose monitoring” (perception of healthcare support, concerns, strengths, and alarm management), and “experience regarding the disease” (self-management of the disease and safety). Despite the fact that diabetes mellitus is a complex chronic disease, all participants provided a positive assessment of their progress and improved control through continuous glucose monitoring. Conclusions: All participants felt more secure and protected with continuous glucose monitoring, improving their quality of life. The main concern among the subjects was the possibility of the sensor failing. They positively valued the alarm system in case of hypoglycemia. The CGM is a highly effective tool for the management and self-control of diabetes and promotes the relationship between patients and professional health. Impact: The findings of this study have important implications for clinical care, highlighting the need for more training and more health education at the first level of health care, such as health centers. Full article

Background and Clinical Significance: As a common inflammatory skin disorder, acne vulgaris is classically associated with sebum overproduction, follicular hyper keratinization, and Cutibacterium acnes proliferation. Emerging evidence suggests a link between severe or treatment-resistant acne and metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. This case series aims to explore the clinical overlap between acne and metabolic dysfunction and highlight the relevance of multidisciplinary evaluation. Case Presentation: Three patients with severe acne vulgaris and coexisting metabolic abnormalities were evaluated at a dermatology clinic in Oradea, Romania, between 2023 and 2024. Each patient underwent dermatologic examination, laboratory testing for metabolic and hormonal parameters, and individualized treatment. Management strategies included topical/systemic acne therapies combined with metabolic interventions (lifestyle modifications, metformin (in two cases), and lipid-lowering agents). Case 1 (female, 23) had obesity, insulin resistance, dyslipidemia, and polycystic ovary syndrome (PCOS). Case 2 (male, 19) presented with central obesity and atherogenic dyslipidemia. Case 3 (male, 18) showed insulin resistance, overweight status, and elevated inflammatory markers. All three showed suboptimal response to standard acne treatment. Adjunct metabolic management resulted in partial improvement within 3 months. One patient required isotretinoin after metabolic stabilization. Conclusions: These cases underscore the interplay between acne and metabolic dysfunction. Insulin resistance and systemic inflammation may contribute to therapeutic resistance in acne. Early recognition of metabolic syndrome features in patients with severe acne may improve treatment outcomes. Dermatologists should consider metabolic screening to guide comprehensive, multidisciplinary care. Full article

Asthma has traditionally been viewed as a single disease, but recent research reveals its clinical and molecular complexity. This perspective highlights the need to shift from a traditional, uniform treatment paradigm to one that embraces the heterogeneity of asthma across individuals. Each patient presents a unique clinical story shaped by a complex interplay of genetic predispositions, developmental programming during critical early-life windows, the influence of sex and hormones, and lifelong environmental exposures. Asthma comprises multiple subtypes with distinct clinical and biological features. Furthermore, lifestyle factors such as obesity and smoking, along with highly prevalent comorbidities like allergic rhinitis and gastroesophageal reflux disease, significantly modify the disease’s course and response to treatment. This article explores how classifying the disease into clinical phenotypes (observable characteristics) and molecular endotypes (underlying mechanisms)—particularly the distinction between T2-high and T2-low inflammation—provides a crucial framework for managing this complexity. The application of this framework, guided by biomarkers, has enabled the development of targeted biologic therapies that can transform care for specific patient subgroups. Despite these advances, significant challenges remain. The pathophysiology of certain subgroups, particularly non-T2 asthma, remains poorly defined, and there is an urgent need for reliable predictive biomarkers to guide therapy and monitor outcomes. It is our opinion that future studies must adopt a systems-biology strategy, with a multi-omics approach that constructs a comprehensive molecular profile of each patient. This integrative methodology will require the use of advanced computational methods, including machine learning and artificial intelligence, to decipher the complex pathways linking genetic and environmental inputs to clinical disease. In conclusion, this article argues for a more personalized understanding of asthma, urging clinicians and researchers to consider each patient’s unique clinical presentation. Full article

The increasing prevalence of chronic metabolic diseases poses a significant challenge in the modern world, impacting healthcare systems and individual life expectancy. The World Health Organization (WHO) recommends that older adults (65+ years) engage in 150–300 min of moderate-intensity or 75–150 min of vigorous-intensity physical activity, alongside muscle-strengthening and balance-training exercises at least twice a week. However, nearly one-third of the adult population (31%) is physically inactive, which increases the risk of developing obesity, type 2 diabetes, cardiovascular diseases, hypertension, and psychological issues. Physical activity in the form of aerobic exercise, resistance training, or a combination of both is effective in preventing and managing these metabolic diseases. In this review, we explored the effects of exercise training, especially on respiratory and pulmonary factors, including oxygen consumption, pulmonary ventilation, and blood gas analyses among adults. During exercise, oxygen consumption can increase up to 15-fold (from a resting rate of ~250 mL/min) to meet heightened metabolic demands, enhancing tidal volume and pulmonary efficiency. During exercise, the increased energy demand of skeletal muscle leads to increases in tidal volume and pulmonary function, while blood gases play a key role in maintaining the pH of the blood. In this review, we explored the influence of age, body composition (BMI and obesity), lifestyle factors (smoking and alcohol use), and comorbidities (diabetes, hypertension, neurodegenerative disorders) in the modulation of these physiological responses. We underscored exercise as a potent non-pharmacological intervention for improving cardiopulmonary health and mitigating the progression of metabolic diseases in aging populations. Full article

Sleep disorders and stroke are intricately linked through a complex, bidirectional relationship. Sleep disturbances such as obstructive sleep apnea (OSA), insomnia, and restless legs syndrome (RLS) not only increase the risk of stroke but also frequently emerge as consequences of cerebrovascular events. OSA, in particular, is associated with a two- to three-fold increased risk of incident stroke, primarily through mechanisms involving intermittent hypoxia, systemic inflammation, endothelial dysfunction, and autonomic dysregulation. Conversely, stroke can disrupt sleep architecture and trigger or exacerbate sleep disorders, including insomnia, hypersomnia, circadian rhythm disturbances, and breathing-related sleep disorders. These post-stroke sleep disturbances are common and significantly impair rehabilitation, cognitive recovery, and quality of life, yet they remain underdiagnosed and undertreated. Early identification and management of sleep disorders in stroke patients are essential to optimize recovery and reduce the risk of recurrence. Therapeutic strategies include lifestyle modifications, pharmacological treatments, medical devices such as continuous positive airway pressure (CPAP), and emerging alternatives for CPAP-intolerant individuals. Despite growing awareness, significant knowledge gaps persist, particularly regarding non-OSA sleep disorders and their impact on stroke outcomes. Improved diagnostic tools, broader screening protocols, and greater integration of sleep assessments into stroke care are urgently needed. This narrative review synthesizes current evidence on the interplay between sleep and stroke, emphasizing the importance of personalized, multidisciplinary approaches to diagnosis and treatment. Advancing research in this field holds promise for reducing the global burden of stroke and improving long-term outcomes through targeted sleep interventions. Full article

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

Background: Burnout syndrome (BS) is an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. Although there are underlying causes associated with personal attributes, it is generally linked to external factors within the work environment. The aim of the present study was to investigate the impact of lifestyle factors on BS and its dimensions, as well as on suicidal ideation among Spanish professionals dedicated to implant dentistry. Methods: A cross-sectional observational study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was distributed to members of the Spanish Society of Implants. The data were analysed using descriptive statistical methods. Results: A total of 305 participants (20.9%) responded to the questionnaire. Notably, 10.8% of the professionals reported experiencing suicidal thoughts, a factor significantly associated with the presence of BS. The lifestyle factors associated with BS included the following: not engaging in aerobic exercise for at least 30 min per day (p < 0.05), not having hobbies that facilitate mental disconnection from work (p < 0.001), not following a balanced diet (p < 0.0001), having an insufficient social life (p < 0.0001), and experiencing suicidal ideation (p < 0.01). Conclusions: The surveyed dentists generally reported having healthy lifestyle habits. Nevertheless, one in ten professionals acknowledged having experienced suicidal ideation at some point, highlighting a concerning association with BS. Full article

Background/Objectives: Primary liver cancer (PLC), encompassing hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), constitutes a growing global health concern. Metabolic dysfunction-associated Steatotic Liver Disease (MASLD) and Type 2 diabetes mellitus (T2DM) represent a recurrent epidemiological overlap. Individuals with MASLD and T2DM (MASLD-T2DM) are at a higher risk of PLC. This scoping review highlights the epidemiological burden, the classic and novel pathogenetic frontiers, and the potential strategies optimizing the management of PLC in MASLD-T2DM. Methods: A systematic search of the PubMed, Medline, and SCOPUS electronic databases was conducted to identify evidence investigating the pathogenetic mechanisms linking MASLD and T2DM to hepatic carcinogenesis, highlighting the most relevant targets and the relatively emerging therapeutic strategies. The search algorithm included in sequence the filter words: “MASLD”, “liver steatosis”, “obesity”, “metabolic syndrome”, “body composition”, “insulin resistance”, “inflammation”, “oxidative stress”, “metabolic dysfunction”, “microbiota”, “glucose”, “immunometabolism”, “trained immunity”. Results: In the MASD-T2DM setting, insulin resistance (IR) and IR-induced mechanisms (including chronic inflammation, insulin/IGF-1 axis dysregulation, and autophagy), simultaneously with the alterations of gut microbiota composition and functioning, represent crucial pathogenetic factors in hepatocarcinogenesis. Besides, the glucose-related metabolic reprogramming emerged as a crucial pathogenetic moment contributing to cancer progression and immune evasion. In this scenario, lifestyle changes, simultaneously with antidiabetic drugs targeting IR-related effects and gut-liver axis, in parallel with novel approaches modulating immunometabolic pathways, represent promising strategies. Conclusions: Metabolic dysfunction, classically featuring MASLD-T2DM, constitutes a continuously expanding global issue, as well as a critical driver in PLC progression, demanding integrated and personalized interventions to reduce the future burden of disease. Full article

Osteoarthritis (OA) remains a major contributor to pain and disability; however, the current management is largely reactive, focusing on symptoms rather than preventing irreversible cartilage loss. This review first examines the mechanistic foundations for pharmacological chondroprotection—illustrating how conventional agents, such as glucosamine sulfate and chondroitin sulfate, can potentially restore extracellular matrix (ECM) components, may attenuate catabolic enzyme activity, and might enhance joint lubrication—and explores the delivery challenges posed by avascular cartilage and synovial diffusion barriers. Subsequently, a practical “What–How–When” framework is introduced to guide community pharmacists in risk screening, DMOAD selection, chronotherapeutic dosing, safety monitoring, and lifestyle integration, as exemplified by the CHONDROMOVING infographic brochure designed for diverse health literacy levels. Building on these strategies, the P4–4P Chondroprotection Framework is proposed, integrating predictive risk profiling (physicians), preventive pharmacokinetic and chronotherapy optimization (pharmacists), personalized biomechanical interventions (physiotherapists), and participatory self-management (patients) into a unified, feedback-driven OA care model. To translate this framework into routine practice, I recommend the development of DMOAD-specific clinical guidelines, incorporation of chondroprotective chronotherapy and interprofessional collaboration into health-professional curricula, and establishment of multidisciplinary OA management pathways—supported by appropriate reimbursement structures, to support preventive, team-based management, and prioritization of large-scale randomized trials and real-world evidence studies to validate the long-term structural, functional, and quality of life benefits of synchronized DMOAD and exercise-timed interventions. This comprehensive, precision-driven paradigm aims to shift OA care from reactive palliation to true disease modification, preserving cartilage integrity and improving the quality of life for millions worldwide. Full article